BACKGROUND: Sulfonylurea is recommended to be taken before meal. But since premeal administration is against Koreans usual medication habit, it can be the cause of poor compliance. Such recommendation is based on the results of a few clinical trials about appropriate medication time. But most of the clinical studies had a limitation : observe only acute effects of medication, subjects were only healthy volunteer. So the chronic effect of sulfonylurea of each kind must be validated. METHODS: From 1996 May to 1996 July, data were collected from diabetic patients who visited an university hospitals for managing diabetes and used a intermediate-acting sulfonylurea. The subjects were randomized to two groups of premeal group and postmeal group, by chart number and were asked to take the previous medicine according to assignment. After 1 month medication, mixed meal tolerance test was done with 300Kcal carbohydrate, 400+/-50Kcal diet. The subjects were switched to the other group and 2nd mixed meal tolerance test was done 1 month later. The Area under curves was calculated in preand post-prandial glucose curve and was compared by paired t-test. RESULTS: During the study period, total 16 diabetic patients were enrolled. There was no significant statistical difference between pre-prandial group and post prandial group in AUC. CONCLUSIONS: Intermediate-acting sulfonylurea can be administered at any time in relation to meaL.
Area Under Curve ; Compliance ; Diet ; Eating* ; Glucose ; Healthy Volunteers ; Hospitals, University ; Humans ; Meals

Among the skeletal tuberculous spondylitis is high incidence and curable disease, if early diagnosis and treatment are possible. We reviewed clinical manifestations and radiologic analysis of 30 cases tuberculous spondylitis from May 1983 to Sept. 1986, at Yeungnam medical center, Yeungnam University. The results were follows: 1. The frequent involve sites were thoracolumbar vertebra. 2. The continuous lesion is 86.7% of the all cases. 3. The most common type was intervertebral type, and lytic and sclerotic lesion were same incidence. 4. Paravertebral abscess, kyphosis and disc space narrowing were demonstrated more than 80.0% of the cases. 5. Computed tomography was more accurate diagnostic method rather than conventional plain study to evaluation of extent of lesion, involvement of spinal canal and cord, and size and location of paravertebral abscess. And CT guided abscess drainage procedure was helpful to diagnosis and treatment. 6. Ultrasonography was helpful to differential diagnosis between paravertebral abscess and other solid mass, and useful to follow up study of paravertebral abscess after treatment.
Abscess ; Diagnosis ; Diagnosis, Differential ; Drainage ; Early Diagnosis ; Follow-Up Studies ; Incidence ; Kyphosis ; Methods ; Spinal Canal ; Spine ; Spondylitis* ; Ultrasonography

Allergic contact dermatitis is a prototype of delayed hypersensitivity reaction. Langerhans cells, keratinocytes and T lyrnphocytes play major roles in the pathogenesis of allergic contact dermatitis. We observed Langerhans cells and keratinocytes in contact sensitized epidermal sheets of mice and performed mixed epidermal cell lymphocytes reaction with normal epidermal cells and contact sensitized epidermal cells to determine the lymphocyte stimulating capacity of contact sensitized epidermal cell. We obtained following results : 1. The Langerhans cells were decreased in number and morphologically damaged in contact sensitized epidermis. 2. Ia antigen expression on keratinocytes was detected in almost all contact sensitized epidermal sheets. 3. The allogeneic lymphocyte stimulating capacity of contact sensitized epidermal cells was greater than that of normal epidermal cells. 4. The allogeneic lymphocyte stimulating capacity of contact sensitized epiderrnal cells was lost after treatment of epidermal cells with anti Ia antibody and complement. From these results, it is conceivable that the contact sensitized epidermal cells can amplify the immune reactions by stimulating the lynphocytes which are infiltrated in contact sensitized epidermis.
Animals ; Complement System Proteins ; Dermatitis, Allergic Contact ; Epidermis ; Histocompatibility Antigens Class II ; Hypersensitivity, Delayed ; Keratinocytes ; Langerhans Cells ; Lymphocytes ; Mice*

BACKGROUND: The HLA system is known to be the most polymorphic genetic system in human and there are characteristic racial differences in the distribution of HLA antigens, alleles, and haplotypes. This study was performed to examine the frequency of HLA antigens, alleles and haplotypes in Koreans. METHODS: Two thousand healthy Koreans registered for unrelated bone marrow donors were subject to the study. HLA-A, B and C antigens were typed by the serological method, and HLA-DR DNA typing (low resolution) was done by PCR and reverse hybridization. HLA allele and haplotype frequencies and linkage disequilibrium values were calculated by the maximun likelihood method using the computer program of the 11th International Histocompatibility Workshop. RESULTS: HLA antigens identified in 2000 Koreans were 14 in A locus, 33 in B locus, 8 in C locus and 12 in DR locus. Alleles showing frequencies of more than 10% in decreasing order of frequency In each HLA locus were A2, A24, A33, All, B44, B62; CBL, Cw3, Cwl, Cw7, DR4, DR2, DRl3, DR8, and DR9. Among A-B, C-B, B-DR 2-locus haplotypes, A33-B44, A30-B13, Al-B37, Cwl-B54, Cw4-B62, B7-DR1, B37-DR10 showed strong positive linkage disequilibrium (Chi-square > 1000). The most common A-B-DR haplotypes in Koreans occurring at frequency of more than 2% were A33-B44-DRl3 (4.8%), A33-B58-DRl3 (3.2%), A33-B44-DR7 (2.6%), All-B62-DR4 (2.3%), A24-B7-DR1 (2.3%), and A30-Bl3-DR7 (2.1%) Comparison of the distribution of A-B-DR haplotypes among east Asian populations reveals that Koreans are most close to Japanese, but show higher degree of polymorphism in the distribution of HLA haplotypes compared to Japanese. CONCLUSIONS: The results obtained in this study can be used as basic data for Koreans in the fields of organ transplantation, disease association studies and anthropologic studies.
Alleles ; Asian Continental Ancestry Group ; Bone Marrow ; DNA Fingerprinting ; Education ; Haplotypes* ; Histocompatibility ; HLA Antigens* ; HLA-A Antigens ; HLA-DR Antigens ; Humans ; Linkage Disequilibrium ; Organ Transplantation ; Polymerase Chain Reaction ; Tissue Donors ; Transplants

No abstract available.
Child* ; Humans ; Hypertension, Portal*

Acute cavitating pulmonary infection with a mycetoma is sometimes occur in immunocompromised patient. Most mycetoma lesions are due to Aspergillus species, and lesion caused by Candida species is rare. So we report an experienced case that pulmonary and rib infection caused by Candida species-'in -AML patient and complete remission with previous reports.
Aspergillus ; Candida albicans* ; Candida* ; Candidiasis ; Humans ; Immunocompromised Host ; Lung Diseases, Fungal ; Mycetoma* ; Ribs

Two cases of Bleeding Meckel's Diverticulum Using (99m)Technetium-Pertechnetate Scanning are presented. (99m)TC-pertechnetate was used in the diagnosis of Meckel's Diverticulum by Jewette et al in 1970 for the first time. The affinity of this isotope for the parietal cell of the gastric mucosa makes it ideal for delincating ectopic gastric tissue. It noninvasiveness can be used in early screening test of occult gastrointestinal bleeding in pediatric age group.
Diagnosis* ; Gastric Mucosa ; Hemorrhage* ; Humans ; Mass Screening ; Meckel Diverticulum* ; Rabeprazole ; Sodium Pertechnetate Tc 99m*

Magnetic resonance (MR) is rapidly emerging technique that provides high quality images and potentially provides much more diagnostic information than do conventional imaging modalities. MRI is conceptually quite different from currently used imaging methods. The complex nature of MRI allows a great deal of flexibility in image production and available information, and key points are as follows. 1. MR offers a non-invasive technique with which to generate in vivo human images without ionizing radiation and with no known adverse biological effects. 2. Imaging mechanism of MRI is quite different from conventional imaging modality and for more accurate diagnostic application, It is necessary for physician to understand imaging mechanism of MRI 3. M.R. makes available basic chemical parameters that may provide to be useful for diagnostic medical imaging and more specific pathophysiologic information which are not available by alternate techniques. 4. M.R. can be produced by number of different methods. This flexibility allows the imaging technique to be applicated for particular clinical purpose. Multiplanar and three dimensional imaging may extend the imaging process beyond the single section available with current CT. 5. Future directions include efforts to; a. Further development of hard ware b. More fastening scan time c. Respiratory and cardiac gated imaging d. Imaging of additional nuclei except hydrogen. e. Further development of contrast media f. MR in vivo spectroscopy g. Real time MR imaging
Comprehension* ; Contrast Media ; Diagnostic Imaging ; Humans ; Hydrogen ; Magnetic Resonance Imaging ; Pliability ; Radiation, Ionizing ; Spectrum Analysis

PURPOSE: Metalloproteinases (MMPs) and tissue inhibitors of metalloproteinase (TIMPs) have been linked to the angiogenic process in general. In order to understand the potential roles of MMPs and TIMPs in corneal neovascularization process, we examined the expression and activities of MMP-2, MMP-9, TIMP-1 and TIMP-2 during the course of suture-induced corneal neovascularization in rat model. METHODS: Corneal neovascularization of rat cornea was induced by suturing. The expression of MMP-2, MMP-9, TIMP-1 and TIMP-2 in sutured corneas was examined by immunohistochemistry and reverse transcription-polymerase chain reaction (RT-PCR). The activities of MMP-2 and MMP-9 were measured before and after suture by gelatin zymography. RESULTS: MMP-2 proenzyme, and TIMP-1, -2 were expressed in normal corneas, predominantly in corneal epithelium. After injury, expression of MMP-2, MMP-9, TIMP-1 and TIMP-2 increased, notably in healing corneal epithelium, infiltrating inflammatory cells, stromal fibroblasts, and ingrowing vascular endothelial cells. The intensity of immunostaining and enzymatic activities of MMP-2 and MMP-9 paralleled the magnitude of inflammatory cell infiltration, which peaked around day 7 after suture. Immunoreactivity of MMP/TIMP decreased significantly two weeks after suturing. At day 35 after suture, staining of MMP-2, TIMP-1, -2 remained visible only in corneal epithelium and vascular endothelial cells. CONCLUSIONS: MMPs as well as TIMPs were upregulated during suture-induced corneal neo-vascularization, suggesting that both may take part in extracellular matrix remodeling in the corneal wound healing, inflammatory, and neovascularization processes.
Animals ; Cornea ; Corneal Neovascularization* ; Endothelial Cells ; Epithelium, Corneal ; Extracellular Matrix ; Fibroblasts ; Gelatin ; Immunohistochemistry ; Matrix Metalloproteinase 2* ; Matrix Metalloproteinases ; Metalloproteases ; Models, Animal ; Rats ; Stromal Cells ; Sutures ; Tissue Inhibitor of Metalloproteinase-1* ; Tissue Inhibitor of Metalloproteinase-2 ; Wound Healing

This study was conducted to assess the referral patterns to specialist from general practitioners in health center and perceived needs of referred patients for specialist care in health center. The study subjects were 249 patients who visited to health centers and were referred to other medical facilities. The data were obtained from questionnaire survey which was conducted in Kyongjuu-city Health center, Seongju-Gun Health center and Koryong-Gun Health center in Kyongsangbuk-Do, from June 10 to october 17, 1995. The total referral rate was 2.7%. The proportion of patients who wished to be referred to medical specialists was 85.9%, and the proportion of patients referred by general practitioners in health centers was 14.1%. Among the patients who wished to be referred to medical specialists, 45.9% visited directly to health centers, 34.6% visited health centers via local clinics and 19.5% visited health centers to get referral permission only. The reasons for getting referral permission in health centers were easy geographical accessibility(34.6 %), easy to get referral permission in health centers(27.l%), and very difficult to get referral permission in local clinics(l6.4%). Among the diseases of referred patients, diseases of the musculoskeletal system and connective tissue were most prevalent on a whole, but diseases of nervous system and sensory organs were comparatively high among the patients who wished to be referred to medical specialists and infectious and parasitic diseases were comparatively high among the patients referred by general practitioners in health centers. The most favorable medical facility was general hospital including university hospital in both groups of patients who wished to be referred to medical specialist and the patient referred by general practitioners in health centers. Regarding the needs for specialist care in health center, 75.2% patients who wished to be referred to medical specialists and 74.3% of patients referred by general practitioners in health center wanted the specialist care. The most frequently requested speciality is internal medicine(47.1%), and then orthopedics and general surgery. Based on above results, this study revealed that the majority of patients referred from health center wished to be referred to medical specialists at their own will, so, referral system at health center level should be changed. And if specialist care in health center be provided, the medical care by internist could be provided first, and then that of orthopedics and general surgery could be provided. These kinds of medical cares could be covered by local clinicians as a part-time job on a voluntary basis.
Connective Tissue ; General Practitioners ; Gyeongsangbuk-do ; Hospitals, General ; Humans ; Musculoskeletal System ; Nervous System ; Orthopedics ; Parasitic Diseases ; Surveys and Questionnaires ; Referral and Consultation* ; Specialization*